US6056746A - Electrosurgical instrument - Google Patents
Electrosurgical instrument Download PDFInfo
- Publication number
- US6056746A US6056746A US09/049,728 US4972898A US6056746A US 6056746 A US6056746 A US 6056746A US 4972898 A US4972898 A US 4972898A US 6056746 A US6056746 A US 6056746A
- Authority
- US
- United States
- Prior art keywords
- electrode
- exposed
- treatment portion
- fluid
- contact surface
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1485—Probes or electrodes therefor having a short rigid shaft for accessing the inner body through natural openings
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/1206—Generators therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1402—Probes for open surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1482—Probes or electrodes therefor having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/1206—Generators therefor
- A61B2018/1246—Generators therefor characterised by the output polarity
- A61B2018/126—Generators therefor characterised by the output polarity bipolar
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B2018/1472—Probes or electrodes therefor for use with liquid electrolyte, e.g. virtual electrodes
Definitions
- Cavity distension provides space for gaining access to the operation site, to improve visualisation, and to allow for manipulation of instruments.
- liquid rather than gas is more commonly used due to better optical characteristics, and because it washes blood away from the operative site.
- the particular staggered arrangement shown affords the surgeon a view of the tissue contact electrode tip, and permits a large range of applied angles with respect to the tissue surface, which is particularly important in the confined spaces typical of endoscopic surgery.
- the electrode assembly 32 includes a central, active or tissue contact electrode 34 which is made of platinum, platinum/iridium or platinum/tungsten, and is constituted by a generally hemispherical exposed tip 34A and an integral central conductor 34B.
- the conductor 34B is electrically connected to a central copper conductor 34C by fastening a thin stainless steel spring 34D over the adjacent end portions of the conductors 34B and 34C, thereby providing an electrical connection between the handpiece of the instrument and the exposed tip 34A.
- a ceramic insulation sleeve 36 surrounds the conductor 34B, the spring 34D and the adjacent end portion of the copper conductor 34C.
- the sleeve 36 has an exposed portion 36A which surrounds the distal end portion of the conductor 34B.
- the value of "r” changes when the active electrode 34 contacts tissue, the higher the value of "r” the greater is the propensity of the electrode assembly 32 to enter the vaporisation mode.
- the fluid medium heats up. Assuming the fluid medium is normal saline (0.9% w/v), the temperature coefficient of conductivity of the fluid medium is positive, so that the corresponding impedance coefficient is negative.
- the impedance initially falls and continues to fall with increasing power dissipation to point "B", at which point the saline in intimate contact with the electrode assembly 32 reaches its boiling point. Small vapour bubbles form on the surface of the active tip 34A and the impedance then starts to rise. After point "B", as power dissipation is increased further, the positive power coefficient of impedance is dominant, so that small increases in power now bring about large increases in impedance.
- the electrode assembly 32 is introduced into a selected operation site with the active electrode tip 34A adjacent the tissue to be vaporised, and with the tissue, the active tip and the return electrode 38 immersed in the saline 78.
- the RF generator is activated to supply sufficient power (as described above with reference to FIG. 4) to the electrode assembly 32 to vaporise the saline and to maintain a vapour pocket surrounding the tissue contact electrode.
- FIG. 7 illustrates the use of an electrode unit similar to that of FIG. 2 used for tissue desiccation.
- output power is delivered to the electrodes in a first output range, so that current flows from the active electrode 34 to the return electrode 38.
- the output power causes the saline solution adjacent to the active electrode 34 to become heated, preferably to a point at or near the boiling point of the saline solution. This creates small vapour bubbles on the surface of the active electrode 14 that increase the impedance about the active electrode 34.
- An outer insulating polyimide coating 40 surrounds the proximal portion of the shaft adjacent the return electrode 38, thereby providing the return electrode with an annular fluid contact surface extending from the edge of the coating 40 to the insulation sleeve 36.
- the insulation sleeve 36 has a distal end face 36A of a diameter such that the step radius (i.e. the distance between the circumferential edge of the end face 36A and the outside diameter of the active electrode 34) is at least 1/20th of the length of the exposed active electrode treatment portion 34A.
- the insulation sleeve 36 thus has a shoulder (or step) which is coaxial with the active electrode 34. In use, this step prevents local arcing which could otherwise occur at the proximal end of the exposed active electrode treatment portion 34A, rendering the distal end of the treatment portion 34A ineffective.
- the power demand is considerably higher as a result of the vaporisation voltage presented across the low impedance wetted region of the active electrode treatment portion.
- the clinical effect is not only the required vaporisation, but also a potentially undesirable thermal damaging effect resulting from the increased power dissipation. This effect may, however, be beneficial in these types of electrodes which are typically used for cutting, wherein it is desirable to seal blood vessels simultaneously with the cutting action.
- Partial enveloping of the active electrode treatment portion 34A can be largely avoided by ensuring that the ratio of the length of the conductive path between the furthermost point of the active electrode treatment portion and the length of the shortest conductive path between the active electrode treatment portion and the fluid contact surface is less than or equal to 2:1, i.e. b/(a+c) ⁇ 2 (see FIG. 8).
Abstract
Description
Claims (33)
Applications Claiming Priority (8)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
GBGB9512889.8A GB9512889D0 (en) | 1995-06-23 | 1995-06-23 | An electrosurgical instrument |
GB9512889 | 1995-06-23 | ||
GB9512888 | 1995-06-23 | ||
GBGB9512888.0A GB9512888D0 (en) | 1995-06-23 | 1995-06-23 | An electrosurgical generator |
GB9600355 | 1996-01-09 | ||
GBGB9600352.0A GB9600352D0 (en) | 1996-01-09 | 1996-01-09 | Electrosurgical instrument |
GBGB9600355.3A GB9600355D0 (en) | 1995-06-23 | 1996-01-09 | Electrosurgical instrument |
GB9600352 | 1996-01-09 |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US08/702,512 Continuation-In-Part US6004319A (en) | 1995-06-23 | 1996-06-20 | Electrosurgical instrument |
Publications (1)
Publication Number | Publication Date |
---|---|
US6056746A true US6056746A (en) | 2000-05-02 |
Family
ID=27451303
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US08/702,512 Expired - Lifetime US6004319A (en) | 1995-06-23 | 1996-06-20 | Electrosurgical instrument |
US09/049,728 Expired - Lifetime US6056746A (en) | 1995-06-23 | 1998-03-27 | Electrosurgical instrument |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US08/702,512 Expired - Lifetime US6004319A (en) | 1995-06-23 | 1996-06-20 | Electrosurgical instrument |
Country Status (13)
Country | Link |
---|---|
US (2) | US6004319A (en) |
EP (2) | EP1025807B1 (en) |
JP (1) | JP3798022B2 (en) |
KR (1) | KR100463935B1 (en) |
CN (1) | CN1095641C (en) |
AR (1) | AR002570A1 (en) |
AU (1) | AU710619B2 (en) |
BR (1) | BR9609421A (en) |
CA (1) | CA2224858C (en) |
DE (2) | DE69634014T2 (en) |
ES (2) | ES2150676T5 (en) |
IL (1) | IL122713A (en) |
WO (1) | WO1997000647A1 (en) |
Cited By (792)
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US6179836B1 (en) | 1992-01-07 | 2001-01-30 | Arthrocare Corporation | Planar ablation probe for electrosurgical cutting and ablation |
US6183469B1 (en) | 1997-08-27 | 2001-02-06 | Arthrocare Corporation | Electrosurgical systems and methods for the removal of pacemaker leads |
US6190381B1 (en) | 1995-06-07 | 2001-02-20 | Arthrocare Corporation | Methods for tissue resection, ablation and aspiration |
US6203542B1 (en) | 1995-06-07 | 2001-03-20 | Arthrocare Corporation | Method for electrosurgical treatment of submucosal tissue |
US6224592B1 (en) | 1992-01-07 | 2001-05-01 | Arthrocare Corporation | Systems and methods for electrosurgical tissue treatment in conductive fluid |
US6228082B1 (en) | 1995-11-22 | 2001-05-08 | Arthrocare Corporation | Systems and methods for electrosurgical treatment of vascular disorders |
US20010001314A1 (en) * | 1997-06-13 | 2001-05-17 | Arthrocare Corporation | Electrosurgical systems and methods for recanalization of occluded body lumens |
US6238391B1 (en) | 1995-06-07 | 2001-05-29 | Arthrocare Corporation | Systems for tissue resection, ablation and aspiration |
US6264650B1 (en) | 1995-06-07 | 2001-07-24 | Arthrocare Corporation | Methods for electrosurgical treatment of intervertebral discs |
US6277114B1 (en) | 1998-04-03 | 2001-08-21 | Gyrus Medical Limited | Electrode assembly for an electrosurical instrument |
US6283961B1 (en) | 1996-07-16 | 2001-09-04 | Arthrocare Corporation | Apparatus for electrosurgical spine surgery |
US6309387B1 (en) | 1995-11-22 | 2001-10-30 | Arthrocare Corporation | Systems and methods for electrosurgical skin resurfacing |
US6364877B1 (en) * | 1995-06-23 | 2002-04-02 | Gyrus Medical Limited | Electrosurgical generator and system |
US6363937B1 (en) | 1995-06-07 | 2002-04-02 | Arthrocare Corporation | System and methods for electrosurgical treatment of the digestive system |
US6443970B1 (en) | 2001-01-24 | 2002-09-03 | Ethicon, Inc. | Surgical instrument with a dissecting tip |
US6458128B1 (en) | 2001-01-24 | 2002-10-01 | Ethicon, Inc. | Electrosurgical instrument with a longitudinal element for conducting RF energy and moving a cutting element |
US6464702B2 (en) | 2001-01-24 | 2002-10-15 | Ethicon, Inc. | Electrosurgical instrument with closing tube for conducting RF energy and moving jaws |
US20030014051A1 (en) * | 2001-06-18 | 2003-01-16 | Arthrocare Corporation | Electrosurgical apparatus having compound return electrode |
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US6557559B1 (en) | 1992-01-07 | 2003-05-06 | Arthrocare Corporation | Electrosurgical systems and methods with temperature control |
US6558410B1 (en) * | 2000-11-28 | 2003-05-06 | Remotelight, Inc. | Cardiac deblocking device and method |
US20030088245A1 (en) * | 2001-11-02 | 2003-05-08 | Arthrocare Corporation | Methods and apparatus for electrosurgical ventriculostomy |
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Also Published As
Publication number | Publication date |
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JP3798022B2 (en) | 2006-07-19 |
CN1193268A (en) | 1998-09-16 |
DE69634014T2 (en) | 2006-03-02 |
CA2224858A1 (en) | 1997-01-09 |
JPH11507857A (en) | 1999-07-13 |
ES2150676T5 (en) | 2006-04-16 |
AU6132196A (en) | 1997-01-22 |
KR100463935B1 (en) | 2005-05-16 |
AR002570A1 (en) | 1998-03-25 |
CN1095641C (en) | 2002-12-11 |
KR19990028364A (en) | 1999-04-15 |
EP0771176B2 (en) | 2006-01-04 |
DE69609473T2 (en) | 2001-04-26 |
IL122713A0 (en) | 1998-08-16 |
CA2224858C (en) | 2006-11-14 |
US6004319A (en) | 1999-12-21 |
EP0771176A1 (en) | 1997-05-07 |
EP1025807B1 (en) | 2004-12-08 |
EP1025807A2 (en) | 2000-08-09 |
EP0771176B1 (en) | 2000-07-26 |
EP1025807A3 (en) | 2000-10-04 |
IL122713A (en) | 2001-04-30 |
DE69634014D1 (en) | 2005-01-13 |
BR9609421A (en) | 1999-05-18 |
ES2150676T3 (en) | 2000-12-01 |
WO1997000647A1 (en) | 1997-01-09 |
DE69609473T3 (en) | 2006-09-28 |
MX9800249A (en) | 1998-07-31 |
ES2233239T3 (en) | 2005-06-16 |
DE69609473D1 (en) | 2000-08-31 |
AU710619B2 (en) | 1999-09-23 |
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